Payor Enrollment Coordinator

Select Physical Therapy•Plano, TX

23h•Hybrid

About The Position

The Payor Enrollment Coordinator manages all phases of non-delegated payor enrollment and re-credentialing for providers, practitioners, and facilities. The coordinator works with internal teams, payors, and other external partners to resolve claim rejections, confirm credentialing requirements, ensure contracting accuracy, and track enrollment and credentialing status. The role also maintains credentialing data and payor enrollment portals, including CAQH, with current provider and facility information. This is a full-time hybrid position based at the Credentialing OP Division in Plano, Texas. The schedule is Monday through Friday, 7:30 a.m. to 4:30 p.m. Central Time, and compensation is $20.00 per hour. Select Medical describes its Outpatient Division as a nationally recognized outpatient physical rehabilitation leader with more than 1,900 locations across 46 states and the District of Columbia.

Requirements

At least 2 years of experience in credentialing or a related healthcare field.
Proficiency in Windows, including Word, Excel, and Access.
Ability to communicate assertively and professionally with internal and external partners to influence resolution of issues.
Strong oral and written communication skills and the ability to interact professionally and positively at all organizational levels.
Detail-oriented, with strong organizational skills and the ability to maintain accuracy while meeting deadlines and production requirements.
Ability to work independently and collaboratively with a team.

Nice To Haves

Experience working in a hospital and/or with Medicare.
Experience in payor enrollment, facility enrollment, and Medicare/Medicaid.
Knowledge of credentialing processes, terminology, and NCQA standards.
Strong analytical skills, including process improvement and problem resolution.

Responsibilities

Manage all phases of the non-delegated payor enrollment process for providers and facilities.
Determine why claims are rejected and work with external sources to identify the best resolution.
Partner with the Contracting department to determine payor credentialing requirements.
Understand payors and their requirements, build relationships within an assigned territory, and identify the appropriate contacts for questions and resolutions.
Review contracts for accuracy and partner with payors to ensure proper credentialing status.
Complete payor enrollment and re-credentialing for facilities and practitioners with applicable contracted non-delegated payors.
Work with CVO Coordinators to collect payor enrollment requirements, including signature pages, state licenses, and proof of liability.
Complete and track health plan credentialing and enrollment for practitioners and facilities.
Serve as a company source of information about non-delegated payor credentialing activity status.
Maintain the credentialing database with relevant payor tracking and data.
Monitor provider and facility status in internal and external data systems related to non-delegated payor enrollment.
Maintain payor enrollment portals, including CAQH, with current contact information, license effective dates, and certificates of liability.